Association of Haematological Parameters with Disease Activity Score-28 in Rheumatoid Arthritis

BACKGROUND Rheumatoid arthritis is a chronic autoimmune disorder that causes joint inflammation, pain and stiffness. Early diagnosis and management of RA can prevent deformities and improve quality of life. This study aims to investigate the correlation between haematological parameters (hemoglobin, mean platelet volume, total platelet count, red cell count, total leukocyte count, neutrophil- lymphocyte ratio or NLR and platelet-lymphocyte ratio or PLR) and DAS-28 (Disease Activity Score-28) in RA patients. Specifically, we are exploring the relationship between NLR, PLR and DAS-28, which has not been extensively studied previously. METHODS The study comprised 30 RA (Rheumatoid Arthritis) patients with moderate disease activity and 30 RA patients with high disease activity, aged 40-70 years, and 30 healthy controls. The RA patients were diagnosed according to 2010 American College of Rheumatology criteria, with a minimum disease duration of one year and controlled co-morbidities, including diabetes and hypertension. Data analysis was done by using SPSS software version 24. A p-value <0.05 was taken as statistically significant. Confounding variables like diabetes, hypertension and smoking were adjusted by logistic regression analysis. RESULTS Compared to healthy controls, RA patients showed a statistically significant decrease in RBC count and hemoglobin levels, and a significant increase in total leukocyte count, platelet count, mean platelet volume and neutrophil-lymphocyte ratio (p-values: 0.02, <0.001, <0.001, 0.005, <0.001, and 0.045, respectively). Similar statistically significant differences were observed between RA patients with moderate and high disease activity. However, no significant difference was found in platelet-lymphocyte ratio between RA patients and healthy controls. CONCLUSIONS Thus, there is a positive association between haematological parameters and disease activity in rheumatoid arthritis patients. NLR can act as an additional tool in identifying people with high disease activity and such people can be given more proactive and intensive care, which can lead to better health outcomes and a decrease in disease-related complications and deaths.